Beyond Day Six
My sometimes-daily blog of a photograph or two with a few words, celebrating all the days of life that flow through creation into perspiration, inspiration, reflection, sabbath, and resurrection.
Then this is a good place to be. The iris began blooming this week. This particular iris bloomed three times last year, with the third time in December.
The rhythm of the bloom parallels my chemotherapy pattern. I feel relatively good before each treatment. And then I have ten days of fatigue, mouth sores, more hair loss, increased vulnerability to infection. It is challenging for me not to see these days as loss. And then I gain strength, preparing for the next round. Ready to bloom.
I still find it incredible that I have had two different forms of cancer within a year.
Each bloom signals there are possibilities and recoveries.
The second chemotherapy treatment was completed Monday. And despite my impatience about getting started, the infusion was largely uneventful. The nurse even advised that I crunch on ice chips during the administration of "the red devil".
The magic blinking green firefly attached to my waist dispensed the dose of Neulasta yesterday evening. Other than the daily dose of prednisone, the medications of the second round are completed.
Now begins the obstacles following each chemotherapy treatment.
My first obstacle is realizing that chemotherapy and radiation will occupy most of my spring and summer. My last chemotherapy should be May 31, if there are four.
I imagine radiation will begin in July.
Another obstacle is lots of fatigue, which all in all, is the lesser of side effects. And is the product of the chemotherapy working. Unfortunately, it is just an extension of the isolation we practiced for a year before we received our vaccinations in February.
The other obstacle is my vulnerability to infection because of the destruction of white blood cells.
But there is a way through this.
Just as the rocks loom in Acadia National Park, there is a path around them. The obstacles do not block the way to my healing. Just one step at a time.
This is my Neulasta Day, for the second time. This evening the little marvel pictured below will dispense medication during a 60 minute time span that will stimulate my white blood cell production. Three weeks ago the little machine, attached near my waist, began blinking it's little green light and made a ticking sound. That first evening, it was just another one of the mysteries that accompanied my chemotherapy. But I have come to realize that it is essential for my recovery.
Created just 20 years ago, this medication and its automated delivery system will help my body develop healthy white blood cells to replace the cancerous ones that were dangerous to my health.
I am so grateful to physicians and researchers and scientists who are dedicated to eradicating cancer.
Yesterday, prior to my treatment, Dr. Thompson said the bone marrow biopsy was negative which was great news.
And to those who read yesterday's blogpost, I ate a whole peanut butter sandwich this time!
Today is the second long day of chemotherapy. I am scheduled to be at Tennessee Oncology for six hours.
The last time I could not distract myself from what was happening. I took my Kindle, two other books, and a notebook. And a peanut butter sandwich.
I did not open the books nor the Kindle nor the notebook.
I ate half of the peanut butter sandwich.
This time I'd rather think pleasant thoughts and consider beauty,
and rest in God's hands, the support of prayer partners, and the care of my medical team.
This photo, with a watercolor effect, is the wild columbine in front of our home.
Eugene Peterson's The Message renders a portion of Psalm 4: "Why is everyone hungry for more? 'More, more,' they say. 'More, more.' I have God's more-than-enough, more joy in one ordinary day."
Judy and I have made a practice to name our blessings each night. Some nights, she does it for both of us when I am so weary, noticing what had brought joy to us during the day. Truly, I am...
The image below, that I have shared before, is from the old Chain of Rocks bridge (old route US 66) spanning the Mississippi River. I entitled it "Unexpected Joy." Do you see it? Do you have it?
My second chemotherapy treatment is in 2 days, Monday. I think I am three weeks wiser. At least when it comes to this specific combination of ten medications and how my body responds, I am three weeks wiser. I still cannot recite the list, nor can I spell their names if I hear them read aloud, nor can I even pronounce them correctly. Still, I think I am three weeks wiser.
I am no longer worried about how tired I will be, not as much as I feared. I am far more vulnerable to infections that first week after treatment than I realized before. I already have some medications that could be necessary for side effects I did not have and for those that I did have.
I have more hope than three weeks ago. Green is, indeed, growing in all the cracks.
And I have a greater sense of a vast network of prayers and encouragement for which I know that I am embraced with grace.
And I am three weeks closer to being cured.
We are fortunate to have two large oak trees at the western edge of our property. Well, maybe not so fortunate in the autumn as they generate thousands of large leaves that descend upon us. But they are magnificent trees.
And we have squirrels. Too many squirrels. Big fluffy squirrels. And they have a partnership with the oak trees. The squirrels keep busy in late summer as the acorns mature and drop to the ground. These fuzzy creatures gather the acorns, one at a time (just one is a mouthful), and bury it somewhere in the yard, frequently in one of the daylily gardens.
I think the intention of the squirrel is to retrieve the acorns to eat during the winter. We find little holes throughout the yard where the squirrels have dug up a winter meal.
But some of the buried acorns are forgotten or not needed. And they sprout. A new oak tree begins.
The gardener at the Hideaway is not pleased by these surprise oak trees. So she flexed her muscles and pulled up this oak tree all by herself.
She's excited by her efforts and has to show her photographer husband.
Life is truly a wonder.
Wherever, whenever it happens.
I began having annual physical exams in my late 40s. I've been pretty healthy all those years with the exception of being overweight, or under-tall. So I would see my lab results which usually were a collection of numbers in the normal range. And I knew little about white blood cells other than they fought infections. Consequently, because I am an inherent learner and as a result of being diagnosed with Diffuse Large B Cell Lymphoma and confronted with new lab results with unfamiliar categories, I wanted to know more.
There are three main groups of white blood cells: monocytes, granulocytes, and lymphocytes. (1) Monocytes are present in larger numbers when the body fights off chronic infections. They target and destroy the cells that are causing the illness. (2) Granulocytes are the white blood cells that contain proteins, and have three different cell subgroups. Basophils are less that 1% of WBC and focus on allergic reactions. Eosinophils respond to infections that are caused by parasites, as well as the inflammatory response of the body. Neutrophils are the majority of white blood cells and act as scavengers. They surround and destroy bacteria and fungi. These neutrophils were 3.1 before my first treatment and .4 one week later, important cells that were killed, along with cancer cells, by the cancer meds. And that's why I have to be careful around other people following each treatment. (3) The third group are lymphocytes with three subgroups. Natural killer cells attack and kill viral cells as well as cancer cells. T cells help recognize and remove infection-causing cells. B cells produce antibodies to help the immune system mount response to infection. My cancer is because B cells are running amuck, and will destroy the lymph structure which is why it is such a problem if it is discovered late.
So what fascinates me about this is how much white blood cells act like a team. Their joint purpose is to protect the body against infection and each one acts in concert with the others to help the body remain healthy by performing their respective purpose. These bodies within which our spirits dwell are amazing. Mine has worked wonderfully well for more than 73 years, approaching 27,000 days. Dr. Thompson and his team intend to make it possible that I have many more days. Thank them, thank God, and thank my many prayer partners.
I took this photo at Old Car City USA, White, Georgia. It's an iconic junkyard where none of the cars or their parts are for sale and where they charge you $10 extra if you bring a camera. Fun spot if you like old cars!
I've been thinking about resilience. I took this photo in January at Navarre Beach, Florida, because I noticed how this plant was not only growing in the sand, but blooming. Not just surviving. Blooming. My hero.
Resilience is toughness: being able to endure and recover from difficulty. Resilience is elastic: being able to bounce back from defeat. Resilience is strength: able to absorb adversity. Resilience is being embraced with grace.
Not just surviving. Blooming.
Yesterday my hair began to fall out. I told the pharmacist that it's not as much a shock for a man that's already bald. A friend asked, will you lose your eyebrows? They warned me that I could lose all body hair. I think that includes eyebrows. I wonder if it includes ear and nose hair, not that I have any noticeable, because of my good grooming habits! HA!
Next Monday I have my second chemotherapy treatment. And I have been going over the treatment plan to understand what I am receiving. I receive 10 medications with each cycle. The first 8 take about 6 hours, one after another, with constant monitoring by the care team.
1) Tylenol tablets
2) Benadryl, 50 mg, first time was liquid in my IV, during which I jumped all over the chair, not pleasant
3) Dexamethasone, a glucorticosteroid, treats nausea and lymphoma
4) Fosnetupitant, used with above medication to treat nausea and vomiting
5) Doxorubicin, the red liquid, that treats cancer by interfering with DNA of cancer cells
6) Vincristine, attacks normal and cancerous cells during cell division, hair loss, causes extensive tissue damage if it escapes the veins
7) Cyclophosphamide, works as above, but attacks normal and cancer cells during rest phase of cell division
8) Rituximab, monoclonal antibody, targeted antibody that attaches to the cancerous B cells and destroys them
9) Neulasta, attached to my waist and automatically dispenses 27 hours later, expensive ($6,231) stimulate WBC production in bone marrow
10 Prednisone, five daily doses, a steroid to decrease my immune systems response to the medications and to reduce reactions
Quite a regime, but far from the most difficult. Explains the fatigue. I'm counting all of this to kill my cancer!
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© Day Six Pix, The Photography of John Hartleroad